Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Radiol. Aug 28, 2011; 3(8): 199-204
Published online Aug 28, 2011. doi: 10.4329/wjr.v3.i8.199
Computed tomography scans of paranasal sinuses before functional endoscopic sinus surgery
Emma C Cashman, Peter J MacMahon, David Smyth
Emma C Cashman, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 21008, United States
Peter J MacMahon, Department of Otolaryngology, Waterford Regional Hospital, Dunmore Road, Waterford, Ireland
David Smyth, Department of Radiology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
Author contributions: Cashman EC wrote the manuscript; MacMahon PJ provided the images and performed the review of the images; Smyth D reviewed and corrected the manuscript.
Correspondence to: Dr. Emma C Cashman, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 21008, United States. emma_cashman@dfci.harvard.edu
Telephone: +353-51-848000
Received: February 10, 2011
Revised: July 16, 2011
Accepted: July 23, 2011
Published online: August 28, 2011

This review aims to familiarize the radiologist with the common types of sinus surgery including their indications and techniques. We also illustrate how surgeons interpret 3D sinus anatomy when evaluating computed tomography (CT) studies. Preoperative evaluation by CT is mandatory for all patients undergoing functional endoscopic sinus surgery (FESS). In the past decade in particular, CT of the paranasal sinuses has become a roadmap for FESS. The radiologist’s goal is to report on five key points: the extent of sinus opacification, opacification of sinus drainage pathways, anatomical variants, critical variants, and condition of surrounding soft tissues of the neck, brain and orbits. We present a systematic approach to the use of coronal, axial, and sagittal images in CT evaluation before FESS.

Keywords: Computed tomography, Sinus, Functional endoscopic sinus surgery, Anatomy, Complications